A push to crack-down on pills available online is the latest battle for anti-abortion advocates after Oklahoma enacted a near-total ban in 2022. 

One Oklahoma bill would have made it a felony to distribute drugs to intentionally cause an abortion. House Bill 3013 passed in the Oklahoma House of Representatives but stalled in the Senate this year. Violators would have faced up to ten years in prison and $100,000 in fines. 

The U.S. Supreme Court is now weighing a case that could limit access to abortion pills nationwide. The U.S. Food and Drug Administration has approved mifepristone in combination with misoprostol to end pregnancy through ten weeks gestation. Mifepristone first received FDA approval in 2000. The FDA took steps in 2016 and 2021 to make the drug more readily available, including allowing it to be delivered through the mail. A group of anti-abortion medical associations has filed a legal challenge to the FDA’s approval of mifepristone. 

More women have turned to self-managed abortion with pills after some states banned the procedure after the overturn of Roe v. Wade in 2022. Oklahoma saw a spike in abortion pill orders after the U.S. Supreme court decision. 

Oklahoma lawmakers and anti-abortion groups have pushed claims that abortion pills are dangerous as they seek to restrict access. We used scientific studies, government information and guidance from medical organizations to fact-check some of their claims. 

Claim: Abortion pills can prevent women from later carrying a pregnancy to term.
Source: Rep. Denise Crosswhite Hader, R-Piedmont, made this claim in a Feb. 2 press release announcing she had filed House Bill 3013.  

“I’m concerned that a woman given these drugs to take in isolation could die by herself, and they could keep her from being able to carry to term a pregnancy at a later date should that be desired,” she said in a statement.
Fact check:  Mostly false 

Medication abortion won’t negatively affect future pregnancies or fertility, according to guidance from the American College of Obstetricians and Gynecologists. One study conducted in China found that women who’d had an abortion using mifepristone were no more likely than women who’d never been pregnant to experience pregnancy complications. Another study of pregnancies in Scotland between 1980 and 2008 found that the likelihood of preterm birth after having an abortion decreased over the length of the study, as medical abortion became more common.  

Rep. Denise Crosswhite Hader sent The Frontier the FDA label for Mifeprex, a brand name for mifepristone. It reads that after using the drug and misoprostol, some patients reported post-abortal infection, including endomyometritis and pelvic inflammatory disease, which could lead to infertility. But the FDA says that because adverse reactions are voluntarily reported, it’s not always possible to estimate frequency or tie them to a drug. 
-Ari Fife

Claim: House Bill 3013 would have made some medications illegal that have a variety of other medical uses, including for chemotherapy and to treat ectopic pregnancy. 
Source: A March 22 column in The Oklahoman by Dr. Dana Stone made this claim.

“The bill also makes it illegal to use the medications Cytotec and methotrexate by designating them as “abortion-inducing drugs,”’ Stone wrote. “Both drugs have been approved by the Food and Drug Administration for many years for a variety of uses.”
Fact check: True but misleading

While the bill named misoprostol (Cytotec) and methotrexate as two prescriptions that are considered abortion-inducing drugs under House Bill 3013, the legislation clearly stated the definition wouldn’t have applied to those medications when prescribed for other uses, such as for chemotherapy, treating ectopic pregnancy or spontaneous miscarriage.
-Ashlynd Huffman

Claim: Abortion pills are dangerous and can send users to the hospital.
Source: Crosswhite Hader said this before the House of Representatives passed the bill on March 14. “These pills are dangerous,” she said. “You are four times more likely to have to go to the hospital when you have a chemical abortion.” 
Fact check: False

Crosswhite Hader cites a 2009 study published in the American Journal of Obstetrics & Gynecology in which researchers used government datasets from women in Finland who were up to 63 days pregnant and had abortions between 2000 and 2006. The rate of adverse events was compared between women who had surgical abortions to women who had medical abortions. That study found that women who receive a medical abortion four times more likely to experience a subsequent adverse reaction, and 20% of women who had medical abortions needed to go to a hospital for complications.

But that study appears to be an outlier. Other scientists questioned how the study came up with its post-abortion adverse event statistics.The study’s authors wrote a response to their peers’ skepticism published in 2010 in the same journal, in which they stated that the study was based on figures submitted to the government registry, rather than a randomized study with strict protocols and definitions, and that actual serious complications following an abortion were “rare.”

“Thus, many of the ‘complications’ are not really such, but rather concerns or adverse events that bring women back to the health care system,” the paper’s authors wrote.

Another researcher, who called the adverse event rates in the 2009 paper “nonsensical,” wrote that the findings were misleading, since adverse event rates reported in the study were 20 to 100 times those reported by other researchers, and that the reports used by the researchers counted office visits by the “worried well” as adverse events.

The 2009 study was also cited in a Texas judge’s reasoning to invalidate federal regulators’ approval of mifepristone, but one of the study’s co-authors criticized the plaintiffs and judge in that case, saying they were purposefully misunderstanding the study. 
-Clifton Adcock

Claim: The risk of death for women from abortion pills is ten times higher than from surgical abortion.
Source: The anti-abortion group Students for Life made this claim in a March 11 post on its website expressing support for House Bill 3013. “The pills are also responsible for causing four times the complications as surgical abortion, with a risk of death that is ten times higher, according to a National Institute of Health Study,” the website claims. 
Fact check: Mostly false

The study Students for Life cited was published in 2006 and relies on data from the 1980s and 1990s to back some of its findings. The authors of the study noted that the risk of death is the same for miscarriages and medical abortions, and the risk of death from live deliveries is ten times higher than miscarriage or medical abortion.

More recently, a 2015 study published by researchers at the U.S. Centers for Disease Control and Prevention showed that of the 108 abortion-related deaths reported from 1998 to 2010, only 20 were related to medical abortions. At least 67 of the deaths were related to a surgical procedure. 

Data from the U.S. Food and Drug Administration shows that between September 2000 to the end of 2022, 32 women died after using mifepristone. The report estimated nearly 6 million women had used the drug to terminate a pregnancy through the end of 2022. Various studies say accurate counts of women who have had abortions of any kind and any related complications are difficult to estimate. Multiple studies, including the study cited by Students for Life, say both medical and surgical abortions are safe, especially when women have access to them earlier in their pregnancies. 

A representative from Students for Life said it was “impossible” to rate their statement as false because of the weak reporting of abortion data in the U.S.
-Kayla Branch

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Claim: Women who turn to pills for self-managed abortions later in pregnancy are at high risk for complications.
Source: U.S. Sen. James Lankford, R-Oklahoma, made this claim during a March 25 appearance on Fox News Radio’s Livin’ the Bream podcast.

“If you are later-term… you’re actually at high-risk of major complications on that. So, that’s why it’s always been done when you see a doctor to determine if you have an ectopic pregnancy, or if you’re later than you thought in your pregnancy so you don’t have that risk.”
Fact check: mixed 

Studies have found medical abortion in clinical settings using mifepristone and misoprostol or misoprostol alone are overwhelmingly safe, according to a 2020 article published in the New England Journal of Medicine. Evidence from other countries including Ireland and Peru has also shown low rates of complications for self-managed medication abortions. But there is a lack of data on complications from self-managed abortions during the second trimester. 

“The mifepristone–misoprostol combination is probably the safest method,” the article found. “The research gap here is important, since approximately two thirds of deaths worldwide from unsafe abortion involve attempts after the first trimester.”

Reports of fatal complications from ectopic pregnancy in patients who took mifepristone are rare, according to available data. Two of the 32 reports of deaths associated with mifepristone between September 2000 and Dec. 31, 2022 were from ectopic pregnancy, according to the FDA. But the deaths could not definitively be linked to mifepristone because of the presence of other drugs and other varying factors. 
-Brianna Bailey

Rating system: 

True: A claim that is backed up by factual evidence
Mostly true: A claim that is mostly true but also contains some inaccurate details 
Mixed: A claim that contains a combination of accurate and inaccurate or unproven information 
True but misleading: A claim that is factually true but omits critical details or context 
Mostly false: A claim that is mostly false but also contains some accurate details False: A claim that has no basis in fact

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